Sickle Cell Education: A Survey of Antenatal Healthcare Givers

Am J Trop Med Hyg. 2019 Sep;101(3):684-688. doi: 10.4269/ajtmh.18-0408.

Abstract

To explore the educational practices of antenatal care providers toward pregnant women with sickle cell disease (SCD) and sickle cell trait (SCT), a survey was conducted among selected doctors and midwives who provide antenatal care at the outpatient clinic of the Obstetric Department of the Korle-Bu Teaching Hospital, Accra, Ghana. The study explored their practices of screening for and patient education about SCD and SCT. Of the 102 respondents, 100(98%) stated that they were knowledgeable in the medical and genetic aspects of the disease. Regarding screening, 82(80.4%) reported mandatory screening for SCD, 9(8.8%) did not offer screening as routine, and 11(10.8%) gave patients the choice. The majority (93.1%) always informed patients when the test was positive but health-care providers less than six years experience were less likely to communicate SCT status to patients without the trait (odds ratio [OR] = 0.41, 95% CI [0.18-0.93]). Nurses/midwives were less likely to tell patients their carrier status (OR = 0.25, 95% CI [0.10-0.59]). There was also variation in referral practices for genetic counseling, with 26.5% always referring, 28.4% never doing so, and 45.1% only referring if the patient had questions. This may affect patients' awareness of this genetic condition. Therefore, continuous medical education on SCD/SCT and standardization of counseling may help inform couples' family planning choices and reduce the burden of the disease on future generation and health care.

MeSH terms

  • Anemia, Sickle Cell*
  • Female
  • Genetic Counseling / standards
  • Ghana
  • Health Knowledge, Attitudes, Practice*
  • Health Personnel / education*
  • Humans
  • Male
  • Mass Screening
  • Patients
  • Prenatal Care*
  • Surveys and Questionnaires